If You’re Private Pay, Rethink your Pricing Structure…NOW.

I see many colleagues in speech or even learning specialists discuss being private pay and the woes in finding clients. They also discuss the ease in documentation. While, I am in a group who thinks that documentation standards should be adhered to no matter private pay or third party reimbursement, I do believe that pricing structures should pivot in private pay.


Well it’s consumer trends. And the over 50% private pay practitioner should know their geography, national consumer trends, and then local consumer trends. These are things we must consider and plan for for vitality in the business world of therapy. I write this as a person who started in private practice with 100% private pay (ABA, ST, OT, Learning Specialists, School Program Development). To his credit, my mentor would supply me with coding booklets and talk to me about insurance. So I wasn’t blind to it. I was just arrogant. Yes…there is an air to the private pay practitioner. I digress. But, here I was 100% private pay and then the market crashed. It sank. And I had to pivot to stay afloat. And I pivoted to insurance.

The pandemics (health and racial), moved businesses especially consumer services to an elevated space of luxury. And brick and mortar businesses had to pivot…fast. Like it or not, many had to move to teletherapy whether we believed in it or not. Fast forward to now and the consumer is reimagining what works for them.

Parents have long shuttled their children to and fro while navigating their own lives and livelihoods. Then resources like Outschool came along. Virtual schools got a second wind. And many private pay practitioners had brick and mortar locations that were empty. Parents were, and still are, rethinking services within a framework of health and safety. Slim options for therapy resources became even slimmer. The practitioner who, for the sake of livelihood, held the unglamorous job of scheduling, driving, and parenting (like many of us) within a pandemic (all of them).

So when we examine, models of reimbursement for the private practitioner…outside of insurance. The model needs to be re-examined. Not our model, just yours…your practice. The only winners in this pandemic are tape, signage, and plexiglass people. But the practitioner …mental health, speech therapy, occupational therapy must quickly understand that this is not about how great your services are, this is about innovation and agility. If your organization is not lean or lean its thinking, you are struggling silently.

Consumers drive the market. Say it aloud…Consumers drive the market. Figure out how consumers are now paying for similar services and readjust your model. Get some data. Study the market. Think about therapy and think more about what services the community need…think business. Not what you think they need…but what they say they need.

Best advice I was given when I started in private practice?

Dr. Wayne Holland (mentor extraordinaire) told me that I had the opportunity to name and develop the model of practice that worked for me.

The keys to agility are awaiting you.

Get agile.


Photo by SHaHraM Anhari on Unsplash

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